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Board extends ER pact to Oct. 31

By Kayla Carter
Staff Writer
[email protected]
Before turning to items on the Unicoi County Memorial Hospital’s Board of Control agenda, Chairman Glenn Tilson addressed the board with a few words about the board’s mission.
“The mission of this board is to do everything we can to provide medical care in Erwin and in Unicoi County for our citizens,” Tilson said. “We need all the help we can get from you. We’re going to do all that we can and due to confidentiality agreements that have been signed, that’s about all I can say at this time, but we are working.”
During the meeting, the board voted to extend a contract with TeamHealth, which currently provides emergency room coverage, until Oct. 31.
“They have been working with us,” said Interim Chief Executive Officer Jete Edmission. “At this point in time we just need to approve it through that point.”
Edmisson said he spoke with the service provider about the potential extension in order to make time for the hospital to seek another contract or staff the ER. “That’s going to depend on whether we can find some local physicians that will work,” Edmisson said. “[UCMH Chief of Staff] Dr. Frank Wegman and I talked about it this weekend whether or not we thought there would be some availability, but at this point in time we are requesting the board approve the extension of the TeamHealth contract.”
Wegman said during his report that he met with an individual to see if they would provide some staff to fill in for the ER. “He basically said he would be willing to help after Oct. 31, but he just does not have the staff prior to Oct. 31,” Wegman said. “He was requesting that maybe some local physicians try to fill in. I don’t really think that’s going to be an option.”
Edmisson said he had time to speak with Mountain States Health Alliance and Wellmont about providing staff for the ER. He also said the hospital has been in contact with external vendors to replace TeamHealth.
“Hopefully with them, they will give us an extra month to be able to make some of those decision,” he said. “We’ve got so many ERs all the way around us, we are hoping we can get a partnership.”
Before the board voted unanimously to extend the contract, Chief Financial Officer Toni Buchanan stated that the contract extension before the board was the same as discussed in a former strategic planning session.
During Buchanan’s financial report she stated that the hospital had “a tough year,” which reflected in a net loss of $557,363 for the year ending in June. “The hospital faced some obstacles this past year, such as increased utilization of Medicare Advantage Programs resulting in higher discounts, TennCare regulations resulting in lower reimbursement [higher discounts and charity care], lower reimbursement from most insurance companies, purchasing some needed equipment, and the NextGen implementation on April 1,” her report states.
The report also states that the hospital’s accounts receivable increased $1,790,115.
The joint commission inspection was conducted on Aug. 7 and 8.
Edmisson said the commission recorded an average number of findings. “We will go through and keep the pressure on and keep working on that,” he said. “We will have some results that we will report in 45 days and some in 60 days.”
The joint commission also addressed the hospital’s method for disseminating information about patient safety and quality improvement.
The board adjourned the regularly scheduled meeting to go into executive session in order to discuss the topic. “Tennessee Code Annotated 68-11-272 allows patient safety and quality improvement information processes, which go from the hospital to the medical staff to the board to be protected throughout the organization and throughout lawsuits down the way; any type of items,” Edmisson said. “It gives you the opportunity to really look at quality improvement and be able to have open discussions. If you look at history, the only way you really have improvement is to assure you’re getting all the data.”
Edmisson presented information at the meeting during the CEO’s report that the hospital’s community value index from 2010 data puts the hospital in the top 20 percentile for the state. He said the valuation includes the hospital’s quality and cost.
Edmisson also compared the hospital to surrounding hospitals based on the hospital’s strength index score of 405. “Elizabethton (Sycamore Shoals) scored 401, Franklin Woods scored a 386 and Johnson City Medical Center scored a 535,” he said. “These two things are external and national accumulations of data where they take different things like quality, patient satisfaction, cost structure and financial liability. These calculations will determine how you are. It impacts us greatly on value-based purchasing that the Medicare uses to pay us.”
Edmisson said that the hospital is also working on making NextGen, a recently added hospital software and data system, more cohesive to the hospital’s daily operations. He mentioned the system was unable to provide certain data for the joint commission, but hospital staff is attempting to get the logistics worked out with the company.
“We’ve been able to find a revenue cycle consultant that could come in and do an analysis of all the tables that we set up in the NextGen system,” he said. “We will bring them in to do an analysis of our current billing systems to make sure we are maximizing reimbursement.”
Edmisson said the hospital received information from Medicare about increased reimbursement for next year. “The potential increase that we will receive in Medicare payments next year right now with this APU reduction, it is looking like it will increase our Medicare reimbursement for inpatients by $23,000 for the whole year.”